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Background:Chemotherapy-caused nausea and vomiting is a health problem in cancer patients. Olanzapine is used with serotonin receptor antagonists plus dexamethasone post Neurokinin 1 receptor antagonists as the antiemetic. Objective: The study aimed to determine the efficacy of (5 and 10) mg of olanzapine with antiemetic drugs against chemotherapy-induced nausea and vomiting. Methods: The study groups are Group S: received triple antiemetic therapy aprepitant at (1-3) day, dexamethasone at (1-4) day, and ondansetron only on the first day. Group O5: received olanzapine 5 mg with triple antiemetic therapy aprepitant (1-3) days, dexamethasone (1-4) day, ondansetron the first day, and olanzapine 5 mg (1-4) days. Group O10: received (olanzapine 10 mg with triple antiemetic therapy) aprepitant (1-3) days, dexamethasone (1-4) days, ondansetron day 1, and olanzapine 10 mg (1-4) days. The cancer was diagnosed by mamograph; the MAT score was used to control chemotherapy-caused nausea and vomiting. Results: Higher acute and delayed nausea was observed in group S than in groups O5 and O10. Overall, nausea control was increased in group S than in groups O5 and O10. There was no significant difference between the different study groups. Conclusion: Olanzapine 5 mg and 10 mg could treat nausea more than triple antiemetic in patients with nausea.

Background: Urinary tract infections (UTIs) are one of the diseases that are widely spreading among women. A number of factors contribute to UTIs, including circumcision, which narrows the opening of the urinary system. Materials and Methods: This cross-sectional study was conducted from April 2019 to February 2021 to detect the frequency of antimicrobial-resistant bacteria isolated from circumcised women attending two Clinics, for Gyncology in Khartoum locality. Conventional methods were used for isolation, identification, and antimicrobial susceptibility testing. A total of 80 midstream urine samples (n = 80) were collected from all female eligible volunteers, of which 40 had been circumcised and 40 had not. Results: The study investigated 80 females aged 7-70 years, with a mean of 29.3 + 13.1 SD. There were 16/40 (40%) circumcised women who were married and 23/40 (60%) single, whereas for non-circumcised women there were 7/40 (17.5%) married and 33/40 (82.5%) single. Among the circumcised patients, 34/40 (85%) had growths compared to 6/40 (15%) of the non-circumcised participants, and UTIs were significantly associated with circumcision (P≤0.001). Circumcised females had a 32 times higher odd ratio (O.R) of UTIs than non-circumcised females. Escherichia coli was the most predominant isolate among circumcised and non-circumcised women (15(37.5%)). The isolated bacteria in circumcised women were moderately sensitive to Augmentin 22/34 (67.7%) and Gentamycin 20/34 (58.8%) compared to other antimicrobial agents; Ciprofloxacin 16/34(47.1%), Cefuroxime 12/34(35.3) and Amoxycillin 10/34 (29.4%) while all Gram negative rods were highly resistant to Nalidixic acid (100.0%). In contrast to non-circumised women; all isolated bacteria were highly sensitive to Gentamicin 6/6 (100.0%) and Cefuroxime 5/6(83.3%), and moderate sensitive to Augmentin 4/6 (66.7%) and Ciprofloxacin 4/6(66.7%). Also all isolated were highly resistant to Nalidixic acid (100.0%) and Amoxycillin 1/6 (16.7%). Conclusion: UTIs and antimicrobial-resistant bacteria were more prevalent among circumcised women than non-circumcised women. E.coli was the most prevalent bacteria among circumcised and non- circumcised women.

Background: Cochlear Implantation has proven beneficial in patients with profound congenital hearing impairments. Performing cochlear implantation in patients with inner ear malformation has always been a matter of dispute as congenital deaf ears may have anatomical malformations and difficulties during operation, it is important to focus on problems and complications that may face the surgeon who is performing this operation.Objective: Evaluate the problems and surgical difficulties encountered in patients with congenital inner ear malformation, who underwent cochlear implantation.Patients and methods: A series of 21 pediatric cochlear implant (CI) patients with known inner ear malformations determined on computed tomography (CT) of the temporal bone who underwent cochlear implantation in the department of otolaryngology in Hospital Martyr Ghazi Al-Hariri and AL-Yarmouk Teaching Hospital, Baghdad, Iraq, during the period from January 2018 to January 2021 were the subjects of the study to determine intraoperative adverse effects of these anomalies regarding electrode array insertion depths, predisposition to cerebrospinal fluid (CSF) leak through the cochleostomy, and associated facial nerve anomalies that can create access problems for scala tympani.Results: The most common inner ear anomalies were wide vestibular aqueduct (15) patients with percentage of (71.4%), incomplete partitions (5) patients with percentage of (23.8%), and common cavity (1) patient with percentage of (4.8%). CSF leak, the most common was CSF ooze (11) patients with percentage of (52.4%), CSF gusher seen in (6) patients (28.6%), and no CSF leak in (4) patients (19%). Facial nerve anomalies, only one case has abnormal position (more superficial and not injured) with a percentage of (4.8%), while in 20 patients (95.2%) no anomaly was detected. Electrode insertion depth, full insertion was achieved in (17) patients with percentage of (81%), while incomplete insertion was occurred in (4) patients (19%).Conclusion: Cochlear implant can be successfully and safely done in patients with selected congenital inner ear anomalies. Surgery can be challenging in certain cases of gusher and facial nerve abnormalities, but proper radiology and good surgical technique will help avoid complications. Keywords: Cochlear Implantation, Congenital inner ear malformation, facial nerve anomalies.

The kings of the inhabitants of Mesopotamia have been constructing different buildings with various purposes, as required by the religious, political, defense, economic and social needs of those buildings. These buildings were distinguished by their different planning according to the purpose of their construction, but they shared many components, the most important of which are building materials and the main purpose of them is to serve the king or ruler and society. The fortresses are among the architectural manifestations in the civilization of Mesopotamia, and they reflect in their planning and construction an important architectural thought that indicates important political, fortification and economic dimensions, as its planning was linked to these civilizational topics. Through the various cuneiform texts with various purposes, we find that they have highlighted important and valuable information about those fortresses, their beginning, their purpose, and when they are urgently needed, and whether they are necessary to build or can they be dispensed with. Through preliminary induction of cuneiform texts, we find that the ancient kings and rulers built these fortresses for a necessary purpose that was directly related to the defensive aspect of the city and its residents, and they differ in their sizes depending on the location of the city, its large size, the population census and its political status. Through our research, we shed light on the most important cultural data related to the fortresses, what they are, the most important names, the places in which they are located, the building materials constructed from them, as well as highlighting the cuneiform texts related to each of these cultural colors associated with the forts.

Background: Overuse of electronic gadgets has been highlighted as a possible preventable risk factor for eyesight loss. Excessive use of electronic gadgets, on the other hand, has been linked to vision impairment in a variety of ways. Methods: This was an analytical cross-sectional study to spotlight on the relationship between visual impairment and addiction to electronic devices use. The study's goal was to see if there was a link between Saudis' vision impairment and their addiction to using electronic devices, this is the suitable design for this research. The study was carried out among Saudi population. Data were collected from general population using questionnaire during the period from 22 August to 22 November 2020. Results: The study included the participation of 344 participants from both genders and different age groups in the Kingdom of Saudi Arabia. There were 211 female participants (61.3%) and 133 males (38.7%) took place in this study. The most prevalent age group was under the age of 25 years (n= 111, 32.3%) followed by the age group 25-35 (n= 104, 30.2%) while the least frequent age group was above 45 years (n= 54, 15.7%). On asking the participants whether they think that they have vision impairment or not, their answers were as follows: yes (n= 156, 45.3%), no (n= 131, 38.1) and maybe (n= 57, 16.6%). Due to the use electronic devices, there were 107 participants complained of headache (31.1%). And this was significantly related to the number of hours spent by study participants using electronic devices (P= 0.002) as well as significant for female gender more than male gender (P= 0.03). Conclusion: The study showed statistically significant relationship between the number of hours spent on using electronic devices and visual impairment among study participants especially among female population more than male population. There is a need for awareness campaigns to increase health awareness among population to cut down the use of electronic devices.

Background Nutritional support is essential as enteral or parenteral nutrition to reduce catabolism, to lower the complications rate, and to improve outcomes in critically ill patients. Results The median, range age of the cohort was (median 10, range 6–18.8 months). One-hundred thirteen (62.8%) were males, and 67 (37.2%) were females. The higher frequency of sepsis, ventilator-acquired pneumonia (VAP), and mortality founded in the group received PN. Frequency of sepsis was 15 (16.7%), VAP was 5 (5.6%), and the mortality rate was 11.1% in EN group, while frequency of sepsis was 37 (41.1%), VAP was 23 (25.6%), and the mortality rate was 27.8% in PN group (P = 0.001, 0.001, 0.01, respectively). Median of weight gain on the EN group was 0.17 kg at 2nd week which was more than those in PN group (P = 0.001). The mean ± SD time for reaching the caloric target for those receiving early EN was 4.0 ± 1.9 days which is earlier than that of PN group (6.2 ± 1.7 days) (P = 0.001). There is no significant difference between both groups as regard pediatric intensive care unit (PICU) stay length and mechanical ventilation stay length. Conclusion Early EN remains the preferred route for nutrient delivery as the PN route was accompanied by a lot of complication such as sepsis, VAP, and high mortality rate.

Although hepatitis E virus (HEV) infection has been widely understood as a public health concern in pregnant females, it is sometimes overlooked because of unusual observations of hepatitis E-induced complications during pregnancy. The objective of this descriptive cross-sectional study was to find out how frequent Hepatitis E virus infection is in pregnant women in Sudan. Blood samples were collected from pregnant women (n = 90) attending Khartoum North Hospital from February to December 2019. The specimens were investigated for Hepatitis E virus IgG and IgM antibodies using the commercial kits based on the enzyme immunosorbent assay (ELISA) technique. Out of ninety pregnant women, 36 (40%) were found positive for IgG antibodies, and 5 (6%) were tested positive for IgM antibodies. In addition, 13 (14.5%) of the positive cases are women in their third trimester. These data showed a significant association between previous Hepatitis E virus infection and miscarriage (p

Renal cell carcinoma is the most common type of malignancy in pregnancy. Rupture of renal cell carcinoma is not uncommon. The diagnosis of renal cell carcinoma is often delayed as the clinical presentation might resemble other pregnancy-related disorders or asymptomatic in most cases and a complete ultrasonographic examination of the abdomen is not a part of the routine obstetric evaluation. We report a rare case with spontaneous rupture of renal cell carcinoma in 20 years old in full-term pregnancy primigravida presented by hypertensive disorder and severe abdominal pain with massive retro peritoneum collection, radical nephrectomy was done and the patient life was saved.

Background: Chest wall surgeries are accompanied by severe postoperative pain. Inadequate relief of this pain may lead to both pulmonary complications as lung atelectasis and infection and chronic post thoracotomy pain syndrome. Regional analgesic modalities are important portion of the multimodal therapeutic approach suggested for the management of post thoracotomy pain. Objective: To evaluate serratus anterior plane block as a regional analgesia technique for post thoracotomy and thoracoscopy pain. Recent Findings: Serratus anterior plane block (SAPB), a regional analgesic modality developed by Blanco et al. in 2013, has shown good analgesic effect after thoracotomy and thoracoscopy in many case reports and clinical trials. In such block, a local anesthetic is injected in the fascial plane deep or superficial to the serratus anterior muscle leading to block of lateral cutaneous branches of the intercostal nerves. This provides a sensory block of T2–T9 dermatomes. Conclusion:Serratus anterior plane block as a fascial plane block can be a preferred regional analgesia technique for both post-operative pain management with procedures involving anterolateral chest wall as thoracotomy, thoracoscopy and breast surgery and in cases of multiple rib fractures. This is owing to its easy technique, effective pain relief and potentially better side effects profile compared to other regional modalities and systemic opioids.

Background: Thoracotomy is a very painful surgical procedure that is used to get access into the pleural space, to the lungs, to the heart, to the esophagus or to get access to the thoracic aorta or anterior mediastinum. Objective: To study different modalities of treatment used for post thoracotomy pain control. Recent Findings: Inadequate post-thoracotomy analgesia enhances the postoperative stress response with deleterious effects on respiratory, cardiovascular, gastrointestinal, urinary, immune and coagulation systems. In addition to anxiety and increased risk of Post Thoracotomy Pain Syndrome (PTPS), which can interfere with normal life and may persist for years or even for life? Conclusion: Providing adequate post-thoracotomy analgesia can be challenging, as patients are often elderly or having multiple comorbidities. A multimodal approach is considered in managing post-thoracotomy pain starting with preemptive analgesia and cognitive behavioral modalities in addition to conventional multimodal systemic regimens as opioids, acetaminophen, NSAID, cyclooxygenase (COX)-2-specific inhibitors, gabapentin and pregabalin, steroids, IV lidocaine infusion, ketamine, and many regional analgesic modalities to avoid or decrease adverse effects of systemic regimens. These regional analgesic modalities include thoracic epidural blocks, thoracic paravertebral blocks, intrathecal opioid analgesia, serratus anterior plane blocks, intercostal nerve blocks, interscalene block, erector spinae block and interpleural block.

Background and objectives Inflammatory bowel disease (IBD) is a chronic systemic inflammatory condition that debilitate the quality of life. Multimorbidity, a concept only beginning to emerge in IBD, is defined as two or more comorbidities present in the same individual. Notably, we used the term multimorbidity to refer to two or more comorbidities excluding IBD. Multimorbidity is linked to decreased quality of life, poorer disease outcomes, increased hospitalizations, healthcare costs and polypharmacy complications. We aim to estimate the prevalence of multimorbidity and to explore its effect on IBD patients. Methods We retrospectively reviewed all IBD patients registered in a validated web-based registry since February 2018. Data on patient demographics, comorbidities, IBD and extraintestinal complications were obtained. We analyzed the date using univariate, bivariate and multivariable analysis. Results Among 767 IBD patients, 54.6% had Crohn’s disease (CD), 41.9% had ulcerative colitis (UC) and 3.5% had IBD unclassified. The median age at diagnosis was 22 years (IQR: 15–29). Males compromised 50.2% of patients. According to the Montréal IBD classification, most UC patients had moderate UC (47.8%) while most CD patients had non-stricturing non-penetrating CD (49.8%). Overall, 10.3% IBD patients had multimorbidity and 23.9% had at least one comorbidity. The most common comorbidity was diabetes mellitus (4.9%) followed by essential hypertension (4%) and iron deficiency anemia (3%). Female gender (P = 0.008) and UC (P = 0.005) were more likely to have multimorbidity. Multimorbid IBD patients were more likely to develop thrombosis than non-multimorbid peers (16.7% vs. 1.6%; P Conclusion Multimorbidity is not uncommon among IBD patients, especially females diagnosed with UC. Our findings indicate that future studies are needed to explore the effects of multimorbidity on IBD patients.

Post-orthopaedic operative pain is a serious concern that often requires the administration of analgesics; however, the optimal time of analgesic administration is still inconclusive. Perioperative analgesia is administrating pre-emptive analgesia before and during the surgery followed by postoperative analgesia to decrease the procedure associated nociceptive response. We aim to assess perioperative meloxicam versus postoperative meloxicam for pain control after orthopaedic operations. A systematic review and meta-analysis involving randomized controlled trials from PubMed, Embase, Scopus, WOS, and Cochrane until 28th May 2022. We pooled dichotomous outcomes using risk ratio (RR) presented with a 95% confidence interval (CI) and continuous outcomes using mean difference (MD) with 95% CI. We registered our protocol in PROSPERO with ID: CRD42022336046. We included five RCTs with 964 patients. All the included trials showed high risk of performance and detection biases because of lack of blinding. Pooled analysis favored perioperative meloxicam in reducing pain score after six hours (MD: −0.42 with 95% CI [−0.63, −0.21], p = .0001), 12 h (MD: −0.54 with 95% CI [−0.69, −0.39], p = .00001), and 24 h (MD: −0.23 with 95% CI [−0.36, −0.10]. Pooled analysis favored perioperative meloxicam in improving patient global assessment scale after 12 h (MD: −0.66 with 95% CI [−0.86, −0.46], p = .00001), 24 h (MD: −0.30 with 95% CI [−0.49, −0.11, p = .002), and 48 h (MD: −0.17 with 95% CI [−0.33, −0.01], p = .04). Pooled analysis favored perioperative meloxicam in reducing patient-controlled analgesia (MD: −4.25 with 95% CI [−5.96, −2.54], p = .00001). Short-term pain management after orthopaedic procedures is better accomplished with perioperative meloxicam than postoperative meloxicam. Before recommending perioperative meloxicam for pain control following orthopaedic surgeries, further multicentre trials are still warranted to examine the impact of perioperative meloxicam in different orthopaedic procedures.

In this paper, we are interested in studying entropy and dynamics entanglement between a single time dependent three-level atom interacting with one-mode cavity field when the atomic motion is taken into account. An exact analytical solution for the wave function is given by using Schr\"odinger equation for a specific initial condition. The field entropy of this system is investigated in the non-resonant case. The influences of the detuning parameters and atomic motion on the entanglement degree are examined. We show that both of the detuning parameters and atomic motion play important roles in the evolution of von Neumann entropy and atomic populations. Finally, conclusion and some features are given.

This study aimed to assess the longitudinal predictions between glycated hemoglobin A1c (HbA1c) and physical performance scores in different epidemiological contexts of aging.Longitudinal data of 1,337 older people from three countries (Canada, Brazil and Colombia) of the International Mobility in Aging Study (IMIAS) were used to assess the relationship between HbA1c and Short Physical Performance Battery (SPPB) scores between 2012 and 2016. Linear Mixed Models grouped by sex and adjusted by Age, Study site, Chronic Conditions, Anthropometric Measures, and Inflammatory Level were used to estimate the influence of HbA1c and covariates on SPPB scores.At the IMIAS baseline, Latin American (LA) cities had higher HbA1c averages compared to Canadian cities, with Natal (Brazil) being the city with the highest HbA1c averages in men and women (6.32 ± 1.49; 6,56 ± 1.70 respectively). SPPB scores were significantly lower in LA cities, and older people in Natal had lower SPPB averages in men (9.67 ± 2.38; p-value0.05) and women (8.52 ± 2.33; p-value0.05). In the multivariate mixed linear models of longitudinal analyses, HbA1c was significantly associated with lower SPPB scores in men (β = -0.25, 95% CI: -0.39 to -0.12, p-value = 0.02) but not in women.High HbA1c levels at baseline were longitudinally associated in older adults from different countries, and this association was observed only in men and not in women. This study highlights a possible influence of gender on this relationship.

Background Periodic limb movements during sleep (PLMS) and obstructive sleep apnea syndrome (OSAS) are two frequent coincident sleep disorders. The association of PLMS with OSAS severity and predictors of PLMS in OSAS patients were investigated. Material and method This is a retrospective study that enrolled adult patients ≥ 16 years old who visited the sleep unit at Mouwasat Hospital, Saudi Arabia, between January 2021 and October 2021. All were subjected to full medical history, clinical examination, Epworth Sleepiness (ESS), STOP-Bang questionnaires, and standard overnight polysomnography. Subjects were subdivided into two groups based on PSG findings: group I, OSA patients (153). Patients were classified into mild n = 57 (AHI ≥ 5 and n = 35 (AHI ≥ 15 and n = 61 (AHI ≥ 30). Group II, control group included 100 subjects. Result There was a higher frequency of PLMS in OSA patients vs control group (with a statistically significant value). The study showed a statistically significantly positive correlation between PLMI and each of AHI, hypopnea index, desaturation index, and PLMs with arousal index, in contrast; it had a statistically significantly negative correlation with BMI among the OSA group. By performing multivariate logistic regression to predict the possible factors associated with the existence of PLMS among the OSA group, it was showed that the apnea index and desaturation index were statistically significant predictors. Conclusion The present study showed that OSA patients with PLM were older; had greater AHI, hypopnea index, desaturation index, and PLMs with arousal index; and had lower BMI. Further studies are needed for better understanding this complex relationship.

Purpose Hyperspectral imaging (HSI) systems are becoming potent technologies for computer vision tasks due to the rich information they uncover, where each substance exhibits a distinct spectral distribution. Although the high spectral dimensionality of the data empowers feature learning, the joint spatial–spectral features have not been well explored yet. Gabor convolutional networks (GCNs) incorporate Gabor filters into a deep convolutional neural network (CNN) to extract discriminative features of different orientations and frequencies. To the best if the authors’ knowledge, this paper introduces the exploitation of GCNs for hyperspectral image classification (HSI-GCN) for the first time. HSI-GCN is able to extract deep joint spatial–spectral features more rapidly and accurately despite the shortage of training samples. The authors thoroughly evaluate the effectiveness of used method on different hyperspectral data sets, where promising results and high classification accuracy have been achieved compared to the previously proposed CNN-based and Gabor-based methods. Design/methodology/approach The authors have implemented the new algorithm of Gabor convolution network on the hyperspectral images for classification purposes. Findings Implementing the new GCN has shown unexpectable results with an excellent classification accuracy. Originality/value To the best of the authors’ knowledge, this work is the first one that implements this approach.

This study is an experimental research using a quasi-experimental design with the type of non-equivalent control group pretest-posttest. This research aims to reduce Intrinsic Cognitive Load (ICL) through Inquiry Based Learning (IBL) model based STEM approach. This research was conducted at SMA Negeri 1 Seputih Banyak with the research subjects of class X IPA 1 students and X IPA 4. An data Intrinsic Cognitive Load obtained from essay the pretest-posttest (Task Complexity worksheet). Cognitive load test data analysis was performed using the data normality test, N-gain test and hypothesis test using the Paired Sample T-Test. The experimental class implements the Inquiry Based Learning model based audio and visual using STEM approach while the control class is nonaudio and visual. The results showed by the average value of N-Gain Intrinsic Cognitive Load (ICL) in the experimental class was 0.63 with the moderate category and the control class was 0.18 with the low category. Based on data analysis, can be concluded that there is a positive influence in the form of a decrease in the cognitive load Intrinsic Cognitive Load (ICL) in the experimental class using the Inquiry Based Learning model plus an audio and visual based STEM approach.

The present study was conducted at private Farm at El-Sharqia Governorate, Egypt under supervision of Agronomy Department, Faculty of Agriculture, Suez Canal University, Ismailia, Egypt. Four cultivars of peanut were used in this work namely NC9, Gregory, Bold, and Runner. This work aimed to study the induction of genetic variation in peanut using Sodium azide (NaN3; Mw=65.01) with two doses (1×10-3) and (3×10-3) and three doses of Gamma rays (10, 30 and 50kr) to induce mutagenesis. M1 and M2 seeds per dose for each genotype including the control were sown in a randomized complete block design (RCBD) with three replications in 2017 and 2018 summer seasons. Analysis of variance showed that there were significant differences between genotypes under sodium azide and gamma rays for most studied traits in M1 and M2 generations. Number of primary branches was significantly affected by sodium azide concentrations, however all genotypes gave low number of primary branches under 0.003M than other treatments in both generations. Gregory and NC9 cultivars under Gamma rays had the high number of branches/plant in M1 and M2 generation when treated with 0.001M compared with 0.003M. The average of plant height was affected by radiation mutagen and higher the effect of sodium azide mutagen in both generations. 100-seed weight was affected significantly by sodium azide mutagen more than those by radiation mutagen in both generations. Maximum values of seed yield/plant were recorded for the NC9 followed by Gregory in both generations. NC9 and Gregory had the maximum values of seed yield/plant, when they treated by 0.001m in both generations. Mean values of oil content were increased significantly with increasing concentration of gamma rays doses in M1 and M2 at 10kr, 30kr and 50kr, respectively compared with control. The Bold cultivar had the highest values 51.34% and 50.39% and runner cultivar with values 49.02 and 49.66, when they treated with 50 kr and 30kr in M1 generation. The Runner and NC9 gave the high values for yield and its components and oil content of most genetic parameters under different mutagens in M1 and M2 generations for the most studied traits. The results of heritability, showed moderate to high values for most characters under studied in different mutagens in M1 and M2 generations. Pod yield/plant under the effect of sodium azide appears high positive correlation coefficients with each of seed yield/plant (0.869 and 0.928) during two the generations and 100-seed weight (0.643) in M1 generation

The present study was evaluated fourteen populations of cowpea at Farm of Agriculture Research Station Ismailia, Ismailia Governorate, Egypt. These populations were collected from different regions including one check variety. These were investigated under three levels of watering (100%, 75% and 50% of field capacity), for forage yield, genetic variability and association characters during two successive summer seasons 2017 and 2018 using a Randomized Complete Block Design in a split plot. Analysis of variance was revealed significant variation (P < 0.05) among cowpea genotypes for plant length, number of shoots/plant, dry matter percent, forage fresh and dry yields/plot, expected forage fresh and dry yields/fad and water use efficiency. The irrigation levels had non-significant effects on remain traits {i.e.: plant length, number of shoots/plant in the second season, leaf/stem ratio, dry matter percent, forage fresh and dry yields/plot, expected forage dry yield/fad and water use efficiency}. Moreover, the irrigation levels and cowpea genotypes-interaction had highly significant differences for the studied traits, excepting of number of shoots/plant. Among the fourteen cowpea genotypes through the three irrigation levels, over two seasons (2017 & 2018); the Kenyan genotype named KF-122 was produced significant more crude protein (24.20%) and crude fiber (27.60%), whilst, this genotype; IN-1-14 was produced significant less crude protein (12.20%) and crude fiber (13.90%), furthermore the, the cheek Egyptian genotype named "Buff" was recorded, approximately, average aforementioned value over two seasons. The phenotypic variance (d2p) and phenotypic coefficient of variation (PCV %) were slightly higher than corresponding genotypic variance (d2g) and genotypic coefficient of variation (GCV %) for the quantitative forage characters of cowpea indicated the presence of less environmental effect (d2e and ECV %) upon the concerned characters. Heritability in broad sense estimates was moderate to high for all studied traits

Background Coronavirus disease (COVID-19) pandemic has affected health and lifestyle behaviors of people globally. This project aims to identify the impact of COVID-19 on lifestyle behavior of individuals in the Middle East and North Africa (MENA) region during confinement. Methods We conducted an online survey in 17 countries (Egypt, Jordan, United Arab Emirates, Kuwait, Bahrain, Saudi Arabia, Oman, Qatar, Yemen, Syria, Palestine, Algeria, Morocco, Libya, Tunisia, Iraq, and Sudan) from the MENA region on August and September 2020. The questionnaire included self-reported information on lifestyle behaviors, including physical activity, eating habits, smoking, watching television, social media use and sleep before and during the pandemic. Logistic regression was performed to analyze the impact of COVID-19 on lifestyle behaviors. Results A total of 5896 participants were included in the final analysis and 62.8% were females. The BMI of the participants was 25.4 ± 5.8 kg/m2. Around 38.4% of the participants stopped practicing any physical activities during the confinement (P Conclusions The COVID-19 pandemic was associated with an increase in food consumption and sedentary life. Being exposed to COVID-19 by direct infection or through an infected household is a significant predictor of amplifying these changes. Public health interventions are needed to address healthy lifestyle behaviors during and after the COVID-19 pandemic.

Objectives: To determine the predictive value of lactate dehydrogenase (LDH) in diagnosis of septic shock and its association with other prognostic scores in critical pediatric patients. Methods: A cross-sectional study was performed at Children’s Hospital of Cairo University between June 2019 and December 2019. A total of 200 pediatric patients were divided into the septic shock group [100 critically ill patients with septic shock from the pediatric intensive care unit (PICU)] and the control group (100 patients with only sepsis). LDH was determined in the first 24 hours of admission. The sensitivity and specificity of LDH in diagnosis of septic shock were assessed; the levels of related indicators of patients with different etiologies were compared; correlations between LDH, Paediatric Index of Mortality Π, and Pediatric Sequential Organ Failure Assessment (PSOFA) were analyzed. Results: LDH was 512 μL (406.50-663.00) in the septic shock group and was significantly higher than that (190 μL, range 160.00-264.50) in the control group (P

Health literacy (HL) is essential to access, comprehend, assess and use health data allowing patients to make better health and quality of life decisions. To assess the health literacy level of hemodialysis Egyptian patients, a cross-sectional study from March to September 2020 was conducted at 4 hemodialysis (HD) units on 439 patients. A translated questionnaire including demographic characteristics and health literacy components was conducted. This study adapted Nutbeam’s model incorporating critical health literacy, interactive health literacy, and functional health literacy. Health literacy of hemodialysis patients was satisfactory among 35.5% of the studied patients. The average total score of health literacy questionnaire was (15.53 ± 4.32) distributed as (2.90 ± 1.26) for functional literacy, (3.10 ± 1.26) for basic health knowledge, (1.65 ± 1.21) for communicative literacy, (2.53 ± 0.70) for interactive literacy, (1.75 ± 1.30) for advanced health knowledge, (1.74 ± 0.48) for critical literacy, and (1.83 ± 0.93) for patient safety. It was found that poor health literacy was associated with low income (OR = 2.54, CI 95%: 1.66_3.89, p p p p = 0.033). There was a prevalent low health literacy among the studied regular hemodialysis patients which was affected by education, age and income and in turn it affected the adherence to treatment. Understanding the linkage between HL and self-care attitudes should enhance efforts to improve hemodialysis outcomes.

This work is a first comprehensive survey of true bugs (Hemiptera). A total of 14 species belonging to 14 genera, 12 tribes, 9 subfamilies and 9 families of the suborder Heteroptera and order Hemiptera were recorded and identified in Duhok province, Kurdistan region. A percent 40% of species belonged Pentatomidae family. Date and collecting localities and general distribution with plant association data for each species are given.

During Late Quaternary time, the paleoclimate of the eastern Sahara was punctuated by multiple pluvial periods, then dramatically and cyclically transformed to hyperarid conditions, receiving less than 2 mm/yr of precipitation at present. Geologists, climate modelers, and archaeologists, therefore, have used various proxies to reconstruct past climates during that time, a crucial period for human habitation and migration. These reconstructions, however, lack the precipitation pattern during those pluvial periods, which represents a significant control on weighing the hypotheses of human migrations and occupations. Here we reconstruct the chronology and paleohydrology of a set of fossil rivers expressed by ridges in the modern landscape due to differential erosion. Our 14C and Optically Stimulated Luminescence (OSL) ages of sediments preserved in these ancient rivers cluster within the last African Humid Period (AHP; ca. 14.8 – 5.5 ka BP) and hence support more significant fluvial activity during this distinct humid epoch. Based on median grain size (D50), paleochannel geometry, and drainage area, paleohydraulic reconstructions indicate that typical precipitation intensities of 55–80 mm/h occurred during sediment transport events. When combined with previous annual rainfall estimates, we find that such rainfall intensities were likely 3–4 times more frequent during the AHP. These climatic perturbations may have rendered some parts of the Nile River Valley inhospitable for occupation, driving humans to migrate away in the northwest and west of the Nile Valley between 10.2 and 7.2 ka BP. Ultimately, our results, along with the archeological data, tell a tale from the past of the dramatic climatic changes that our planet undergoes, demonstrating the critical role of climate in sustaining human populations.

تبدو ملامح السرد في شعر النمر بن تولب واضحة في شعره، إذ إن شعره يتميز بكثير من الحكايات السردية بطريقة محبوكة، اشتملت على عناصر سردية تناولها البحث على مستوى البناء السردي، مثل: الزمان والمكان، فضلاً عن الإطار السردي الذي يشمل الحدث والشخصيات والراوي ثم الحوار والوصف، وقد تبين أنّ الشاعر استعمل تلك التقنيات السردية وبدت واضحة في شعره لتشكل ملامح النص السردي لديه...

Objectives: The objectives of the current study were to determine the prevalence of insomnia among students of college of Medicine, Majmaah University, Saudi Arabia and to identify the rate of anxiety-related insomnia. Methodology: The study design was cross-sectional conducted at College of Medicine, Majmaah University. The sample size was taken as 190. Data were collected by a pre-tested questionnaire after obtaining ethics approval. Analysis of data was performed by SPSS. Results: Students with the subthreshold, moderate clinical and severe insomnia were 48.9%, 17.4% and 3.7% respectively. Thirtyfive (50.0%) of students who were insomniacs had mild anxiety. Forty-four (72.1%) and fifty-four (91.5%) students who had moderate and severe anxiety had insomnia respectively. Conclusion: The study concluded that the prevalence of insomnia among medical students, Majmaah University is high. There is a significant association between insomnia and anxiety. More than half of students are complaining of insomnia and anxiety comorbidity.

This study seeks to assess how the conflict in Somalia has transformed over the years and examines the merits of adopting a hybrid approach to peacebuilding. The article argues that given the changes experienced in the conflict and the socio-political and cultural characteristics of the Somali Society, a hybrid peace strategy which combines the traditional Xeer approach and contemporary counter-terrorism strategies can fill the gaps previous peace efforts failed to achieve. This approach has the potential to re-establish the horizontal and vertical social contracts between the people themselves and with the government which had been lost prior to and during the conflict.

BACKGROUND: Postdural puncture headache (PDPH) is a complication commonly related to neuraxial anesthesia and dural puncture, with an incidence proportional to the diameter of the needle, ranging from 2% with a 29G to 10% with a 27G and 25% with a 25G. The development of ne gauge spinal needles and needle tip modication, has enabled a signicant reduction in the incidence of postdural puncture headache. PDPH presents as a dull throbbing pain with a frontal-occipital distribution. PDPH is thought to be due to a cerebrospinal uid leak that exceeds the production rate, causing downward traction of the meninges and parasympathetic mediated reex vasodilatation of the meningeal vessels. The sphenopalatine ganglion (SPG) is an extracranial neural structure located in the pterygopalatine fossa that has both sympathetic and parasympathetic components as well as somatic sensory roots. Sphenopalatine ganglion block (SPGB) has been used for the treatment of migraine, cluster headache and trigeminal neuralgia and can be performed through transcutaneous, transoral or transnasal approaches. Obstetric patients are considered at increased risk for this condition because of their sex, young age, and the widespread use of neuraxial blocks. SPGB is minimally invasive, carried out at the bedside without using imaging and has apparently rapid onset than EBP with better safety prole. The most common side effects of SPGB are all temporary, including numbness in the throat, low blood pressure and nausea. OBJECTIVES: We evaluated the efcacy and safety of lidocaine 2%, lidocaine 5% and bupivacaine 0.5% in transnasal sphenopalatine ganglion block for the treatment of post dural puncture headache on 30 patients. PATIENTS AND METHODS: This prospective, randomized and controlled clinical study was conducted at Sohag University Hospital after its approval by the Ethics and Research Committee of Sohag Faculty of Medicine. Written informed consent was obtained from each patient before participation. RESULTS: Our study showed that there were non signicant differences between the three studied groups regarding age, gender, body mass index, type of operation, onset, site of headache, associated symptoms, relieving factors and exaggerated follow up. There was a nonsignicant difference between the three studied groups regarding changes in visual analogue score for severity of headache. There were nonsignicant differences between the three studied groups regarding presence of bleeding and results of treatment of postdural puncture headache. CONCLUSION: SPGB is an effective initial modality for managing severe headache in patients with PDPH.

Background: Platelet-rich plasma (PRP) is an autologous product derived from whole blood through the process of gradient density centrifugation. Autologous PRP, with growth factors up to 8 times that of normal serum, has been shown to be safe and effective in promoting natural processes of wound healing. Objective: Assessment of the efficacy and advantage in using autologous platelet-rich plasma during myringoplasty in closure of tympanic membrane perforation improving overall outcome. Method: Platelet-rich plasma (PRP) is an autologous platelet-rich concentrate prepared from patients’ own blood with growth factors up to 8 times that of normal serum. The efficacy of PRP when used during myringoplasty is studied. 40 patients with chronic otitis media inactive mucosal disease were randomly chosen and 20 of them was the study group and other 20 were the control group. Both group patients underwent myringoplasty and PRP was used in the study group and the results were evaluated. Myringoplasty was done and after placement of the cartilage graft, platelet-rich plasma was placed over the myringoplasty site. Results: In our study among cases that underwent myringoplasty with use of platelet-rich plasma, 90% had complete tympanic membrane closure and only 10% failure has been noticed. In controls 60% out of cases had failure. The graft take up rate in our study is comparable with the reference studies. Use of PRP accelerated graft uptake. Conclusion: Platelet-rich plasma is a cheap and cost effective platelet concentrate with enriched growth factors. It accelerated the tympanic membrane closure following myringoplasty.

Supplemental material, sj-pdf-1-cnr-10.1177_10547738221074065 for Effects of Emotional Intelligence Training on Symptom Severity in Patients With Depressive Disorders by Mohamed A. Zoromba, Heba E. EL-Gazar, Ahmed Salah, Haitham El-Boraie, Abdel-Hady El-Gilany and Ahmed Hashem El-Monshed in Clinical Nursing Research

Supplemental material, sj-docx-1-cnr-10.1177_10547738221074065 for Effects of Emotional Intelligence Training on Symptom Severity in Patients With Depressive Disorders by Mohamed A. Zoromba, Heba E. EL-Gazar, Ahmed Salah, Haitham El-Boraie, Abdel-Hady El-Gilany and Ahmed Hashem El-Monshed in Clinical Nursing Research

Supplemental material, sj-pdf-1-cnr-10.1177_10547738221074065 for Effects of Emotional Intelligence Training on Symptom Severity in Patients With Depressive Disorders by Mohamed A. Zoromba, Heba E. EL-Gazar, Ahmed Salah, Haitham El-Boraie, Abdel-Hady El-Gilany and Ahmed Hashem El-Monshed in Clinical Nursing Research